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The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2) in patients with primary and secondary Raynaud’s phenomenon. Seventy-eight RP patients and 30 healthy volunteers were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after the MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). After 3 weeks of MLS laser therapy, the clinical improvement manifested by decreasing of the number of RP attacks, mean duration of Raynaud’s attack and pain intensity in RP patients was observed. After MLS laser therapy in 65 % of patients with primary and in 35 % with secondary RP, an increase in the loop number and/or a reduction in avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF and Ang-2 in RP patients was demonstrated. After MLS laser therapy, a reduction of Ang-2 in both groups of RP patients was found. Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.

Introduction: Rheumatoid arthritis is a chronic, inflammatory, systemic complex disease involving joints and periarticular tissues, leading to disability and premature death. The most common and earliest locations of the inflammatory process involves hands. In addition to pharmacotherapy, therapeutic management includes physiotherapy, psychotherapy and patient education. Among the physical therapy methods, the role of laser therapy and magnetotherapy in achieving analgesic effects and improving functions is emphasized. AIM: The aim of the study was to compare the impact of low frequency magnetic field and laser therapy on pain reduction, quality of life and function improvement as well as range of motion hands joints in patients with RA. Material and Methods: The study involved 30 outpatient in the Rehabilitation Clinic of the University Clinical Hospital in Bialystok. Among all patients they were selected into two groups in which they were applied accordingly in the first group a laser stimulation and in the second group a low frequency magnetic field. There were performed 10 treatments in each group with a Saturday - Sunday break. Before and after rehabilitation was conducted a physical and subjective examination, which used: pain examination (VAS scale, Laitinen questionnaire), examination of hand range of motion and functional evaluation according to questionnaires: bMHQ, DASH, AIMS-2. Results: After used of physical therapy in both groups the results were obtained that pain was decreased. Moreover, the magnetotherapy improved the range of motion as well as the quality of life and functionality of patients measured according to the questionnaires: Laitinen, Breif MHQ, DASH, AIMS-2 more favorably than laser therapy. Conclusions: Both treatment: laser therapy and magnetotherapy provide an analgesic effect in patients with RA. It has been shown that magnetotherapy is more effective in improving hand joints mobility and patient’s quality of live.

Introduction: Osteoarthritis (OA) is one of the most common causes of pain in the musculoskeletal system leading to disability. The basic principle of the therapy is the simultaneous use of pharmacological and non-pharmacological treatments. The aim of this study was to evaluate the effectiveness of galvanic and iontophoresis treatments with Perskindol Active Classic Gel (Perskindol) in patients with OA of the knee joints. Moreover, a comparative evaluation of the effectiveness of the application was performed depending on the selection of the active electrode. Material and Methods: The study included 100 patients with gonarthrosis, treated at the Rehabilitation Clinic of the Białystok University Hospital. Three groups were randomly selected: in group I (n = 33), anodic galvanic treatment was applied, group II (n = 33) received iontophoresis with Perskindol gel from the negative pole (“−” iontophoresis), and group III (n = 34) received iontophoresis with Perskindol gel from the positive pole (“+” iontophoresis). The VAS, the Laitinen questionnaire, the Lequesne Index, the Lysholm questionnaire, and the SF-36v2 health survey were used for the clinical evaluation of the patients. Results: In the group of patients who underwent iontophoresis with the use of Perskindol gel introduced from the positive pole, a statistically significant improvement was shown in all the assessed parameters in comparison to the patients who underwent anodic galvanic treatment. Conclusions: The most favorable effect of iontophoresis was observed in the case of iontophoresis with Perskindol gel introduced from the positive pole.

<b>Wstęp:</b> Objaw Raynauda (<i>Raynaud’s phenomenon</i> – RP) charakteryzuje się dużą różnorodnością obrazu klinicznego, uwarun-kowanego stopniem zaawansowania zaburzeń mikrokrążenia. Kapilaroskopia wałów paznokciowych jest najlepszą nieinwazyjną metodą badania i monitorowania zaburzeń mikrokrążenia. Wobec braku satysfakcjonujących wyników leczenia farmakologicznego terapia fizykalna stanowi cenną możliwość poprawy jakości życia pacjentów z RP. <br /> <b>Cel pracy</b>: Ocena klinicznego efektu terapii z zastosowaniem biostymulacji laserowej oraz impulsowego pola magnetycznego niskiej częstotliwości u 48 pacjentów z pierwotnym RP leczonych pentoksyfiliną (tab. I). <br /> <b>Materiał i metody</b>: Ocenę kliniczną oraz badanie kapilaroskopowe przeprowadzono przed terapią, po 3 tygodniach leczenia pentoksyfiliną oraz po 3 tygodniach stosowania zabiegów fizykote-rapeutycznych. Po 3 tygodniach leczenia pentoksyfiliną losowo wyodrębniono dwie grupy, po 24 osoby każda, w których przez kolejne 3 tygodnie stosowano dodatkowo fizykoterapię. W obu grupach zabiegi stosowano 5 dni w tygodniu. W pierwszej grupie chorzy otrzymywali biostymulację laserową (częstotliwość 1500 Hz, dawka 25 J/cm², czas trwania zabiegu 2,5 min). Pacjenci z drugiej grupy otrzymywali po zabiegu biostymulacji laserowej pole magnetyczne niskiej częstotliwości (40 Hz, indukcja 1–5 mT, czas trwania sesji 10–20 min). <br /> <b>Wyniki:</b> Po 3 tygodniach leczenia pentoksyfiliną różnice w liczbie epizodów RP i ich intensywności nie osiągnęły znamienności statystycznej. Mimo że po zastosowaniu fizykoterapii znamienną poprawę kliniczną wykazano u wszystkich pacjentów, nie stwier-dzono istotnych różnic pomiędzy pacjentami po dwóch rodzajach terapii a pacjentami, którzy otrzymywali jedynie biostymulację laserową. Ponadto po zastosowaniu fizykoterapii wykazano poprawę w zakresie zaburzeń mikrokrążenia w badaniu kapilaroskopowym (ryc. 1–3).<br /> <b>Wnioski</b>: W pracy wykazano korzystny efekt kliniczny biostymulacji laserowej u pacjentów z objawem Raynauda, leczonych pentoksyfiliną, aczkolwiek terapia z zastosowaniem pola magnetycznego niskiej częstotliwości nie miała dodatkowego wpływu na poprawę kliniczną. Po zabiegach fizykoterapeutycznych obserwowano również poprawę w zakresie zaburzeń mikrokrążenia w badaniu kapilaroskopowym.